Organization
MONICA SU MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ANN VANESSEN (INSURANCE ADMINISTRATOR)
(805) 955-9990
Entity
Organization
Contact information
Practice address
1000 NEWBURY RD, STE 115, NEWBURY PARK, CA 91320-6435
(805) 375-1633
(805) 955-9966
Mailing address
1000 NEWBURY RD, STE 115, NEWBURY PARK, CA 91320-6435
(805) 375-1633
(805) 955-9966
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A134489
CA
Other
Enumeration date
06/01/2015
Last updated
08/31/2015
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